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Biomedical subjects

J Terry

Publications and source records attributed to J Terry.

At least 19 recordsLinked to original sources
PubMed1987

Increasing survival of dogs subjected to hemorrhagic shock by administration of fructose 1-6 diphosphate.

Previous reports from this laboratory described animal experiments in which intravenous administration of fructose 1-6 diphosphate (FDP) at the onset of hypovolemia, toxemia, and trauma effected improvement in hemodynamic and metabolic parameters, attenuation of tissue damage, and a significant increase in survival. The obvious question remained: Would this agent be as effective if administered after the onset of the shock syndrome? Thus 72 anesthetized dogs were subjected to normotensive hemorrhagic shock and were subsequently treated with FDP at 30 minutes, 1 hour, 90 minutes, and 2 hours after exsanguination. Analysis of the results (as compared with vehicle-treated controls) revealed evidence of improved cardiac output and arterial pressure (p less than 0.02), conservation of effective circulatory volume, better oxygen utilization, and a significant increase in survival (p less than 0.0001). These results, in conjunction with earlier experimental and recent clinical data, indicate that the therapeutic effect of FDP in ischemic and hypoperfusion states is in part metabolically mediated by the augmentation of carbohydrate utilization. Prevention of tissue injury is in part due to the inhibition of generation of oxygen-derived free radicals by neutrophils.

Animals↗
PubMed1985

Stimulating effect of fructose 1-6 diphosphate on the phagocytic function of rat RES and on human leukocyte carbohydrate metabolism.

The phagocytic behavior of the reticuloendothelial system in the rat was assessed by a quantitative technique following fructose-1,6-diphosphate (FDP) administration. In addition, the effect of FDP on the carbohydrate metabolism of human leukocytes was investigated. The rate of colloidal carbon clearance from the blood was increased significantly in the FDP-treated rats as compared to dextrose and saline controls (p less than 0.001). FDP also attenuated the hepatic decrease of ATP (p less than 0.005) and creatine phosphate (p less than 0.005) that has been observed after intravenous administration of colloidal carbon. Carbohydrate metabolism in human leukocytes was enhanced by FDP, with a concomitant increase in ATP content (p less than 0.001). Experimental evidence suggests that FDP intervenes in the Embden-Meyerhof pathway both as a metabolic regulator and as a high energy substrate. These properties of FDP in stimulating the carbohydrate metabolism have recently been described in man.

Adenosine Triphosphate↗
PubMed1983

Cesarean section. Risk and benefits for mother and fetus.

We studied the effects of cesarean section on neonatal mortality for breech infants and low--birth weight vertex infants using data from the Georgia neonatal surveillance network on 392,241 singleton deliveries between 1974 and 1978. The risk of neonatal death for breech infants weighing 4,000 g or less delivered vaginally was significantly higher than the risk for those delivered by cesarean section. The lower the birth weight, the higher the risk for a vaginal breech delivery. For breech infants weighing 1,000 to 2,500 g, the risk was almost 21/2 times greater for a vaginal delivery v a cesarean delivery. The best outcome for high-risk vertex infants weighing 1,000 to 1,500 g was for those delivered by cesarean section in a tertiary perinatal center. An increase in the cesarean section rate may be associated with increased neonatal survival; however, the benefits must be weighed against the costs of an increased maternal mortality and morbidity.

Birth Weight↗
PubMed1983

Neonatal transport in Georgia: implications for maternal transport in high-risk pregnancies.

We analyzed population-based data from the Georgia Neonatal Surveillance Network from 1974 to 1978 to determine the effect of the hospital of delivery on the neonatal mortality rate (NMR) of infants later admitted to neonatal intensive case units (NICUs). The NMR of 3,524 infants transported from primary centers to NICUs was significantly higher [relative risk (RR) = 2.1; 95% CL = 1.9 to 2.3] than that of 10,764 infants born in tertiary centers and admitted directly to an NICU. This effect persisted even after adjustment for birth-weight differences (RR = 1.6; 95% CL = 1.5 to 1.8). The relative risk in favor of delivery in a tertiary center increased with increasing birth weight. However, the proportion of infants of less than 1,000 gm surviving was higher for transported infants and increased with distance transported. This finding suggests that, at these very low birth weights, the hardiest infants were selectively transported. A surprising finding was the very low proportion of low-birth-weight infants delivered in primary centers and transported to NICUs (eg, 32% of infants weighing between 1,001 and 1,200 gm). Our findings support previous reports that delivery in a hospital with an NICU is preferable to later neonatal transport and suggest that efforts to increase the rate of maternal transport in high-risk pregnancies can lead to a substantial reduction in infant deaths.

Adolescent↗
PubMed1983

The effects of fructose-1,6-diphosphate on the isolated rabbit heart.

The effects of 0.1-100 mgm of fructose-1,6-diphosphate (FDP) were observed on the inotropic and chronotropic activity of the isolated, perfused rabbit heart, using a modified Langendorff technique. The preparations were treated with bolus injections of 0.1-100 mgm of FDP in gradually increasing concentrations following their recovery from previous injections. FDP produced a biphasic inotropic response with an initial decrease in contractility followed by an increase. The largest increases in contractility were observed at concentrations below 25 mgm while the greatest decreases occurred at the higher doses. The average maximal increase in contractility was 136.5 +/- 24% at an average dose of 1.53 +/- 0.6 mgm FDP. The average maximal decrease in the inotropic activity was 69 +/- 3% which was observed at an average dose of 92 +/- 8 mgm FDP. Recovery of the contractile activity following the observed effects of FDP was greater than or equal to pretreatment levels at all concentrations except 0.5 and 100 mgm FDP. The basal tone or tension of some hearts, especially after high doses of FDP, increased with some of these preparations contracting into a hard, putty-colored knot. FDP was also observed to exert an anti-arrhythmic effect on arrhythmic hearts. A negative chronotropic response was noted at all concentrations of FDP while a positive chronotropic response was observed only at the 0.1 mgm dose of FDP. The average increases and decreases in heart rate were 65 +/- 18 and 37 +/- 7%, respectively, at average respective doses of 9 +/- 6 and 40 +/- 15 mgm FDP. These data indicate that FDP exerts biphasic inotropic and chronotropic effects as well as an anti-arrhythmic effect on the isolated myocardium. They also indicate that FDP is toxic at higher cumulative doses.

Animals↗
PubMed1981

Epidemiologic characteristics of necrotizing enterocolitis: a population-based study.

The authors studied retrospectively the epidemiologic characteristics of necrotizing enterocolitis occurring among Georgia infants born during 1977 and 1978; 148 cases of necrotizing enterocolitis were identified. The highest incidence rate for necrotizing enterocolitis occurred among infants weighing 751-1000 g at birth and declined with increasing birth weight to less than 0.2 cases per 1000 live births among infants weighing more than 2500 g at birth. The overall incidence rate for blacks was significantly greater than that for whites (1.6 vs. 0.5 cases per 1000 live births, p = 0.01). The overall case fatality ratio was 38.5%; there were no differences in these ratios between blacks and whites. Necrotizing enterocolitis accounted for 15% of all deaths after the first week of life for infants weighting 1500 g or less at birth. If Georgia incidence rates and fatality ratios are applied to 1978 US births, it is estimated that 2210 cases of necrotizing enterocolitis with over 900 associated deaths would have occurred.

Birth Weight↗
PubMed1981

The risk of childbearing re-evaluated.

To determine the completeness of reporting of maternal deaths after live born deliveries in Georgia for 1975 and 1976, we matched death certificates with corresponding birth certificates for women of reproductive age. For these two years, more intensive searching led to our finding a minimum of a 27 per cent higher number of maternal deaths than that found by routine death certificate surveillance. When the delivery-death interval was not restricted to 42 days, use of the record linkage method led to a 50 per cent increase in reporting of maternal deaths. We recommend that special efforts be made to obtain more complete reporting of all pregnancy-related deaths and that completeness of reporting be periodically evaluated for all states.

Adolescent↗
PubMed1980

The underregistration of neonatal deaths: Georgia 1974--77.

We reviewed the neonatal outcome of 3,369 infants who weighed less than or equal to 1500 grams and who were born in Georgia during the years 1974--76. We matched 1,465 of these infants with a death certificate registered in the State's Vital Records. Upon review of the hospital records of the remaining infants, we identified 453 infants that died during the neonatal period without a death certificate being registered. Subsequently, we compared the hospital death registries for 1977 in Georgia and death certificates registered in Vital Records during 1977. We identified an additional 236 infants who died without a death certificate being registered. Forty per cent of these infants weighed greater than 1500 grams. Two major procedural errors regarding the filing of death certificates in Georgia at the local level contributed to this 21 per cent underregistratioon of neonatal deaths in 1974--77. The underregistration occurred disproportionately for rural areas, for unmarried mothers, and for Black infants. The reason for underregistration included failure of hospitals and morticians to file death certificates with the county registrars.

Adult↗
PubMed1977

Common surgical problems of the head and neck.

In most cases of epistaxis, bleeding can be controlled with anterior nasal packing or a Foley balloon catheter. If this fails, posterior packing and otolaryngologic consultation are indicated. In initial assessment of injuries of the head and neck, a classification that is useful divides the region into the following anatomic systems: integumentary, respiratory, vascular, neurologic, musculoskeletal, and digestive. The possible effects of injury on each of these must be considered. The early detection of asymptomatic cancers of the head and neck by primary care physicians depends in large part on a routine of systematic examination and a knowledge of the clinicopathologic course of the disease. A seemingly harmless lump in the neck may well be a cervical node metastasis from an occult primary tumor.

Craniocerebral Trauma↗